Theory Of Planned Behaviour Essay Research Paper

Theory Of Planned Behaviour Essay, Research Paper

The Theory of Planned Behaviour: Nurses Attitudes towards Older Patients

Edmund Fitzgerald O Connor 9724709


The Theory of Planned Behaviour was tested in a survey for its ability to foretell purpose to act in specific ways towards older patients. There were 172 topics from 3 Scots universities, Napier, Edinburgh and Abertay Dundee. The consequences gained from a questionnaire suggest that the Theory of Planned behavior can be used to foretell behavioral purposes of nurses when working with older patients. Nurses purpose to act was predicted by their attitudes largely, perceived behavioral control besides carried a important beta weight although societal norms were found to be non important. The underlying beliefs of attitudes, subjective norms and perceived behavioral controls were besides investigated in footings of anticipation value theoretical accounts. Nurses with positive attitudes towards older patients were found to keep patient orientated values, and occupation satisfaction, more of import than other relevant values. Nurses are besides more motivated to follow with senior staff that may portion their positive attitudes besides. One effect of the present findings is that greater degrees of support by senior staff and ways of increasing occupation satisfaction will better the degrees of attention and intervention for older patients.


Last twelvemonth, for the first clip of all time, the developed states of the universe had more people aged 60 and over than young persons aged 14 and under. For the universe as a whole, the same will be true by the twelvemonth 2043. The per centum proportion of older people in Western Europe is predicted to increase by 14.8 % , 8.8 in Japan and 2.7 % in the U.S. ( U.S Census agency ) .

Two major forces drive the displacement in age distribution. First, birth rates are worsening in most parts of the universe, but particularly in the industrialised states. and 2nd, life anticipation is increasing about everyplace. The U.K is a premier illustration of this phenomenon. In 1999 16 % of the population was 65 and over ( DOH 1999 ) . With the coming of new medical specialty and intervention for more and more unwellnesss and diseases the tendency will increase. The deductions of a human population that is both turning and aging are legion and worrying. Progresss in medical scientific discipline, nutrition and fittingness, and even bioengineering point to the twenty-four hours when many human existences will hold the option of life well past the age of 100 ( CSIS planetary enterprise 99 ) . The aged have been for a long clip the greatest users of health care ( Lefebre et al. 1979 ) . It can be inferred that this demand will go on to lift as the aged population does. About half of the NHS outgo in 1999 was spent on the attention of the over 65 this equates to 5.21 billion lbs ( DOH 1999 ) . From hospital beds to prescriptions the aged were responsible for the greater portion of the cost. In the front line of health care are nurses, who play a primary function in supplying support and proviso The perceptual experience and attitudes of these primary health professionals will greatly impact the response to the turning job. It has antecedently been suggested that these caring services will be stretched to interrupting point in future ( Martin et al. 1988 ; Redfern, 1991 ) .

Past research on attitudes of nurses towards the aged has looked at the many different aspects of primary nursing attention of the aged. At one terminal of the spectrum Robb ( 1967 ) highlighted illustrations of inhuman treatment and maltreatment within the attention of the aged. Similarly in the USA Stannard ( 1973 ) showed that institutionalised inhuman treatment existed on both sides of the Atlantic. Both documents are non con but one merely needs to look in the recent imperativeness to see illustrations of systematic maltreatment and negative attitudes. Harold Shipman was convicted of slaying 15 aged patients in his attention, likewise a nurse was convicted of the slaying of 3 aged patients. Examples such as these, taken with grounds of an increasing aged population, show that the demand to understand the mutual opposition of attention workers attitudes is pressing

The inquiry of which are the right attitudes towards the aged has been a treatment point in the yesteryear. This thought and the survey of current attitudes of attention workers and how they have been formed has been the get downing point of the bulk of work within this field. Looking foremost at the thought of the right attitude Irvine ( 1970 ) suggested that the right attitude towards the aged should be constructed from credence, regard, understanding, and the ability to promote. But the cardinal concept of the right attitude has been brought into inquiry by many. Ingham and Fielding inquiry whether there is a individual right attitude proposing that this is dependent on establishments purposes and the perceptual experience of older people as persons. Institutions are more concerned with smooth running than the demands of single patients. However this philosophical attack is of small aid when turn toing the job and in surveies which show pigeonholing and malcontent in working with the aged, treatment on the rightness of right attitudes has proved of small usage.

Care of the aged has for some clip been an unpopular field within health care ( Ray et al. , 1987 ; Solomon & A ; Vickers, 1979 ; Mutschler, 1971 ) . Past research highlighted the reluctance to work with older patients in infirmaries and nursing places ( Campbell, 1971 ; Gillis, 1973 ; Gunter,1971 ) Why should this be the instance even when the aged are recognised as the group most in demand, in society ( Hardie, 1975 ) ? Psychologists have looked towards pigeonholing and agism for possible replies. Ageism, a term foremost coined by Butler ( 1969 ) , is a procedure of systematic stereotyping of, and favoritism against people because they are old ( Butler & A ; Lewis 1975 p117 ) . Ageism and stereotyping has been developed as a possible ground for the negative perceptual experience and behavior to the aged. Not all research has found comparable consequences. Schoenfeild ( 1982 ) and Treharne ( 1990 ) suggested that in fact there is no grounds to propose negative attitudes towards the aged exists. However the bulk of research has shown negative stereotyping of the aged ( Levin, 1988 ; Ray et al. , 1987 ) . It has been argued that attitudes held by professional workers such as nurses can straight find the quality of attention given to old people ( Wells, 1980 ; Fielding,1986 ; Armstrong-Esther et al. , 1989 ) .

The majority of research on nurses attitudes towards the aged has focused on the degree of preparation and experiences of respondents and how these impacted on their attitudes. A short period of preparation or intercession has resulted in additions in positive attitudes towards the aged ( Gunter, 1971 ; Robb, 1979 ; Tobiason et al. , 1979 ) , the bulk of this work concentrating on nurses. Snape ( 1986 ) nevertheless found contrary grounds. Student nurses who had been developing for 2-3 old ages held more negative attitudes than late enrolled nurses. Snape suggested that this was due to the absence from instruction, of excess straight specific stuff to make with the aged. Other variables such as features of the nurses and patients have been studied including age race, sex, and grade of attention needed. On the topic of grade of attention surveies have shown that the greater the dependence of a patient the greater the negative attitudes shown by the nurse ( Fielding, 1979 ) . The betterments mentioned above ( Gunter, 1971 ; Robb, 1979 ; Tobiason et al. , 1979 ) have largely come from a positive get downing degree. Some research has shown negative attitudes but the bulk has shown impersonal to positive attitudes ( Slevin, 1991 ) . One must first expression at the methodological cogency when approached with this contradiction. One reply to this job is that throughout the different surveies there have been broad scopes of methodological analysiss, which can propose hard in pulling direct comparing.

The bulk of the old surveies have looked at attitudes of nurses and inferred the degree of attention associated. ( Wells, 1980 ; Fielding, 1986 ; Armstrong-Esther et al. , 1989 ) Other surveies have tried to interpret those attitudes into an purpose to act. Study of existent behavior is debatable in certain contexts, and few have attempted this convincingly. Put together, the past research offers a baffled mosaic non rather covering every aspect of a complex inquiry. Previous research has non attempted to divide out and explicate purpose to act from attitudes and seems to lose out wholly other act uponing factors. Past research shows that attitudes although cardinal, are non the lone prognostic factor in explicating behavior ( Wicker, 1969 ; Kraus, 1995 ) . In the present survey an probe into nurses attitudes towards the aged will concentrate on the theory of sound action as a model to foretell an purpose to behaviour and hence the ground for that behavior.


The & # 8220 ; attitude & # 8221 ; concept received its first serious attending from Darwin in 1872. Darwin defined attitude as a motor construct, or the physical look of an emotion. For early psychologists, & # 8220 ; attitude & # 8221 ; was an emotion or thought with a motoric ( behavioral ) constituent. In some instances, the motoric constituent was sub-vocal address ; in other instances, gross behavior, such as postural alteration, was of involvement. Get downing in the 1930 & # 8217 ; s, psychologists began to reason actively about what constituents should consist the attitude construct. Although there was understanding that all attitudes contain an appraising constituent, theoreticians disagreed about whether beliefs ( knowledges ) and behaviours should be included as portion of the attitude construct. The prevalent position among cognitive societal psychologists was that & # 8220 ; attitude & # 8221 ; has both affectional and belief constituents and that attitudes and behavior should be consistent ; i.e. , people with positive attitudes should act positively toward the attitude object.

LaPierre s seminal experiment ( 1934 ) affecting a Chinese twosome in the USA started a immense involvement in behaviour anticipation. There is great trouble in straight researching behavior for matter-of-fact grounds. To procure a dependable step of a given behavior by one would hold to utilize observation ; the research worker would hold to enter the behavior on a figure of perennial occasions. Perceivers would hold to be positioned at all locations where participants might prosecute in the given behavior and record it often. Although non ever of assured cogency, self-reports are clearly more easy obtained. So attitude research frequently focuses on people s attitudes and purpose to act in a certain manner, presuming that they are a placeholder to behaviour. Attitudes are considered to be one of the most indispensable constructs in societal psychological science ( Allport, 1935 ) . Allport theorised that the attitude-behaviour relationship was non uni-dimensional as antecedently thought ( Thurstone, 1929 ) , but multi-dimensional. Attitudes were viewed as complex systems made up of the individual s beliefs about the object, his feelings toward the object, and his action inclinations with regard to the object. Attitudes are one of the cardinal constructs in the theory of planned behavior. Attitude towards a behavior is the sum to which the public presentation of the behavior is positively or negatively valued. Fishbein and Ajzen ( 1975, 1980 ) carried out some of the most influential research within this country of societal psychological science. Fishbein and Ajzen ( 1975, 1980 ) assumed that persons are normally rather rational and do systematic usage of information available to them. Peoples consider the deductions of their actions before they decide to prosecute or non prosecute in a given behavior. They besides pointed out that to mensurate the consequence of attitudes one must be specific. La Pierre for case was inquiring eating house proprietors a general attitude towards Chinese people instead than attitudes towards a well dress couple accompanied by a smart westerner. They argued that attitudes must be specific to certain behavior to hold prognostic consequence.

Figure. 1 The Theory of Planned Behaviour

Fishbein and Ajzen ( 1975, 1980 ) assumed that persons are normally rather rational and do systematic usage of information available to them. Peoples consider the deductions of their actions before they decide to prosecute or non prosecute in a given behavior & # 8221 ; ( Ajzen & A ; Fishbein, 1980 p.167 ) . After reexamining all the surveies they developed a theory that could foretell and understand behaviour an

vitamin D attitudes. Their model, which has become known as the Theory of Planned Behaviour ( TPB ) ( see figure 1 ) , looks at behavioral purposes instead than attitudes as the chief forecasters of behaviors. Theses theories effort to deconstruct the mensurable variables, which combine to impact a individual s behavior. From the diagram above you can see the assorted constituents of the Theory of Planned Behaviour. Behavioural beliefs and ratings, normative beliefs and ratings, control beliefs and motive to follow, attitudes, subjective norms, and perceived behavioral controls, and in conclusion purpose to act. Each will be explored in greater item and their interrelatednesss within the theoretical account.

Most societal psychologists would hold that attitude formation involves cognitive or information processing. This thought is theorised in Fishbein & A ; Ajzen s anticipation value theoretical account ( 1975 ) . This theoretical account suggests that attitudes develop from the beliefs people have about the object of the attitude. Beliefs trade with the representation of the information this person has about a specific object. Beliefs link a given object to an property ; beliefs refers to the personal subjectiveness refering some facet of his/her environment, i.e. , the understanding a individual may hold about the universe. Besides, beliefs consider the subjective chance of a relationship between the given object of the belief and another object, value, construct, or property. Beliefs are formed every bit shortly as an object is linked to an property. In the instance of attitudes refering behavior beliefs link the attitude with a certain result. Although a individual may keep a great many behavioral beliefs merely a comparatively little figure are readily accessible at any clip. The theoretical account goes on to province that by uniting these accessible beliefs and the subjective values of the expected result of the behavior in inquiry you can find the attitude towards the behavior. This can be shown in the undermentioned equation.


AB = biei

I = 1


AB = individual & # 8217 ; s attitude toward the behavior

B = Beliefs the person has about the fact that executing the behavior B leads to a effect or result I

vitamin E = rating of the result I

I = the specific belief figure, from 1 to N

An of import note about the anticipation value theoretical account is that the beliefs concerned must be of a outstanding nature and must be elicited from the respondents themselves.

The normative constituent of the theory trades with the influence the societal environment may hold on behavior. Subjective Norms refers to an single & # 8217 ; s perceptual experience about his equals, household or friends sentiments and how this perceptual experience influences him in whether or non he performs a specific behavior. The theoretical account proposes that the general subjective norm ( SN ) can be obtained by adding the consequences of each generation between the individual & # 8217 ; s outlooks sing the group he considers of import to him, i.e. , his normative beliefs ( NB ) , and his motive to follow ( MC ) with each of the referent group. Similarly as with behavioral beliefs ( precursor to attitudes ) , normative beliefs refer to the sensed behavioral outlooks of of import referents salient to the behavior being investigated. Motivation to follow is the extent to which the topic wants to follow with the referents.

This preparation is presented in the undermentioned equation:


SN = ( NB ) I ( MC ) I

I = 1


SN = individual & # 8217 ; s Attitude toward the Behaviour

NB = normative belief

MC = Motivation to Comply

I = the specific belief figure, from 1 to N

The theoretical account has been used in many attitude surveies in the yesteryear as a model for anticipation of behaviour purpose ( Conner & A ; Sparks, 1996 ; Godin & A ; Kok, 1996 ; Schifter & A ; Ajzen, 1985 ; Terry, Gallois & A ; McCamish, 1993 ) . The Theory of Reasoned Action later was refined to include a 3rd commanding factor on a individual s purpose to act. Perceived behavioral control was added as surveies indicated that when topics did non hold volitional control or perceived volitional control these variables input into the theoretical account returned a greater grade of assurance and success in the theory. Perceived behavioral control was conceptualised as a individual s anticipation of the easiness or trouble of executing the intended behavior ( Ajzen, 1988 ) .

Perceived behavioral control is assumed to once more be preceded by beliefs, in this instance control beliefs. These relate to the perceived presence of factors that may ease or hinder public presentation of behavior. The control beliefs may be based on past experience or influence by second-hand information. The strength of each belief is weighted by the sensed power of the control factor. The merchandises are aggregated in the undermentioned equation.


PBC = curie pi

I = 1


PBC = individual & # 8217 ; s Perceived behavioral control

hundred = Control belief

P = sensed power

I = the specific belief figure, from 1 to N

Ajzen and Madden ( 1986 ) confirmed the hypothesis that the incorporation of the behavioral control constituent allows for more accurate anticipation of behavior such as pupils category attending and class accomplishments, compared with the original version of the theory of reasoned action. The coming of the Theory of Planned Behaviour does non render the Theory of Reasoned Action obsolete. However when behavior is in some manner deemed to be under volitional control of the topic so the Theory of Planned Behaviour would make a more accurate history. Although, each aspect of the theory is of import surveies have shown that harmonizing to the research sphere, each has a greater or lesser influence. Out of 19 Theory of Planned Behaviour surveies Ajzen himself looked at merely 9 were found to hold important influence from the subjective norms, and so this suggests that the consequence of anticipation is specific ( Ajzen, 1991 ) . Attitudes were found to hold the most influence on the purpose to act.

With Ajzen s theory came a figure of unfavorable judgments and alternate theories. Psychologists such and Bentler and Speckart ( 1979, 1981 ) highlighted the importance of wonts when trying to foretell and explicate people s purpose to act. Other variables investigated and found to hold act uponing behaviors are the experient moral duty to demo certain behavior or the relevancy of this behavior for self-identity results ( Gorsuch and Ortberg, 1983 ; Granberg and Holmberg, 1990 ) . Alternate constructions have been hypothesized. Fazio s MODE theoretical account ( motive and chance as determiners of how attitudes influence behavior ) was suggested as Fazio believed that the Theory of Reasoned Action was merely utile when covering with state of affairss where people are extremely motivated and capable of believing intentionally about the attitude and/or the behavior relevant to this attitude ( Fazio, 1990 ) The Southern Cross of this thought was that in a state of affairs were there is a deficiency of motive or sensible ability to entree determination on an attitude behavior dependent issue so extremely accessible attitudes will act upon behaviors as they affect the individuals perceptual experience and judgement of the state of affairs. The premise of purpose to act was critised by many including Eagly and Chaiken ( 1993 ) . They wrote the construct of purposes remains developing in the sound action theoretical account. Purpose might. . . be conceptualized as a continuum running from mistily formulated ideas about future behavior to distinct programs that one is traveling to prosecute in a peculiar behavior at a peculiar point in clip ( p. 185 ) . Simon ( 1981 ) questioned the premise of human rational decision-making, which Azjen postulated was one of the premises the Theory of Reasoned Action took into history. Harmonizing to Simon given the capacity restrictions of human information processing, people do non seek to optimize results through their behavioral determinations but are in general satisfied with any result that is above a subjective degree of aspiration. Persons strive non for maximal public-service corporation but for fulfilling results that can be far short of a theoretically accomplishable upper limit.

Interesting developments of the TRA and TPB have been suggested by a figure of psychologists. These prevarication in the enlargement of the original premiss Azjen made about the ego. In these recent theoretical re-formulations, it is argued that the ego can be deconstructed into a figure of different spheres, such as private ego, personal ego, and interpersonal ego and other broader societal individualities. The private ego can be seen in footings of one s ain experiences and personality traits. The interpersonal ego can be loosely regarded as a signifier of societal individuality and self-categorisation, within a group scenario. The foundations of the Theory of Reasoned Action still hold in these surrogate proposed thoughts. Social norms can be translated into the slang of societal influence in which a group exerts societal force per unit area upon the topic to conform to a given societal ideal or behavior. These thoughts provide ways of explicating the changing grades of influence both attitudes and norms affects one purpose to act. For illustration if a behavior ( presuming the direct correlativity with purpose ) is the merchandise of a state of affairs with personal relevancy to the single so attitudes will play a larger function than the societal norms. If the antonym is true and the state of affairs is borne out from depersonalization so the norms are the better indicant of purpose.

Theory of Planned Behaviour and Health Care

The theory of Reasoned Action has been influential on a figure of past surveies focused on the attitudes of nurses ( Carter & A ; MacInnes,1996 ; Hope,1994 ; J Snape,1989 ) . A figure of surveies across the comprehensiveness of health care have used the Theory of Reasoned Action and Theory of Planned Behaviour as support for their findings ( e.g. Conner and Sparks, 1996 ; Godin, Valois, Lepage and Deshamais, 1992 ; Schifter and Ajzen, 1985 ; Terry, Gallois and McCamish, 1993 ) . With the sphere of nurse health care and their signifier of work it is ill-defined as of yet if attitudes or subjective norms are of greater influence. Past surveies have possibly wrongly taken this subjective theorisation. There are statements for both attitudes being more of import due to the big proportion of interpersonal engagement on the portion of a nurse. Subjective norms can besides claim to hold a greater influence due to the construction of our health care system as a duty hierarchy. The Theory of Planned behavior has non been used before to pattern nurses behaviour in regard to aged patients. Previously the premise has that nurses have volitional control whilst working on a ward with patients. There are nevertheless a myriad of nonvolitional influences, which may good hold a important consequence on a nurses behavior. These nonvolitional factors such as the working environment and infirmary policy, which in a hieratically organized environment such as a infirmary may play an influential function. Past research in wellness attention has frequently over looked these variables. Surely the high degree of interpersonal attention and contact in nurses daily work is straight influenced by the nurses own ego individuality ( Farley, Lehmann and Ryan 1981 ) , so hence attitudes are expected to be significantly prognostic of behavioral purposes. Perceived behavioral control has been shown to be of greatest influence when a individual has old experience and cognition of the mark behavior and environment ( Bentler & A ; Speckart,1979 ; Fredricks & A ; Dossett, 1983 ; Manstead et Al. 1983 ) . Gerontology is a big specialist field in health care and a big proportion of nursing instruction from the beginning of 1st twelvemonth preparation. The theory of planned behavior offers a better architecture in which to integrate these influencing factors.


H1 = The theory of Planned Behaviour can be used to foretell Nurses purposes to act towards aged people.

H2 = Behavioural beliefs and ratings straight correlate with attitudes.

H3 = Normative beliefs and ratings straight correlate with subjective norms.

H4 = Control beliefs and control power straight correlate with sensed behavioral controls.

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